what-is-not-covered-in-your-covid-19-health-insurance-plan

What is Not Covered in your COVID-19 Health Insurance Plan?

Common exclusions under COVID-19 health insurance policies related to treatments and medical expenses.

Written by : Knowledge Centre Team

2025-12-22

990 Views

8 minutes read

The novel Coronavirus (COVID-19) outbreak has been in the news for more than a year now. It has become a major source of concern in our densely populated nation. Needless to say, our country is currently the most affected, so it is critical to be prepared for any unfavorable circumstances ahead of time. A health insurance policy can help to this end. However, with health plans, a common issue is whether or not the novel COVID-19 is covered by medical insurance in India.

What is excluded under COVID-19 health insurance plan?

Your COVID-19 health care coverage does not cover all healthcare treatment costs. Take a look at the exclusions that are not covered under your coronavirus health insurance plan:

  • Home quarantine- Corona health care insurance will not cover the costs that are associated with getting quarantined after getting the coronavirus.
  • Non-recognised quarantine centre- Medical costs incurred when quarantined at a non-recognised facility for coronavirus care will not be compensated by your health insurance policy.
  • Pre-existing diseases- Until the waiting period is completed, any medical costs incurred for the care of any pre-existing conditions will not be compensated by the corona health care policy.
  • Prenatal and postnatal expense- This policy would not compensate the insured party's prenatal or postnatal costs unless they result in the hospitalisation of the policyholder.
  • Hospitalisation without doctor's recommendation- If you are admitted to the hospital without the advice of a medical doctor (as stated on a prescription), your hospitalisation costs will not be covered by the policy.

Is your existing health care plan cover COVID-19 treatment?

Coronavirus is a relatively recent epidemic. However, all current health care plans provide coverage for it. If you bought a health care policy before testing positive, all medical bills related to treatment would be covered as long as you don't get diagnosed during the waiting period.

Since COVID-19 is not a pre-existing condition, it will be included as part of a health care plan's basic hospitalisation costs, which include in-patient hospitalisation, ICU fees, and medical examination fees, among other things. If you do not have health insurance already and plan to have one after testing positive for COVID-19, medical bills will not be covered by it.

Know if all the term plans cover COVID-19?

How to claim the COVID-19 health care insurance?

You have the option of filing a cashless claim or compensation for the expenses that are already paid. Let us look at how both of them work:

  • Cashless claim- If you get treatment for COVID-19 infection at one of your insurance provider's network hospitals, you'll be able to use the cashless treatment option, and you won't have to pay anything yourself. Your insurance company will settle the bill with the hospital.

Check to see if your coronavirus health insurance has a cashless claim option. The list of network hospitals for your insurer can be found in the insurance contract or on the company's official website.

  • Reimbursement claim- Policyholders who are admitted and undergo medical care at a non-network facility of their life insurance company are eligible for reimbursement claims. If you receive COVID-19 care at a hospital that is not in your insurer's network, you will be expected to pay all hospital bills in full when you get discharged.

Once you've been discharged from the hospital, you will need to file a reimbursement claim with your insurance company. To do so, fill out the reimbursement claim form and send the necessary documentation to the insurer within the prescribed time period, including hospital bill payment receipts, investigation and test results, and doctor's prescription.

Coronavirus Health Insurance is a form of insurance that pays for medical expenses related to COVID-19 care. It is intended to cover policyholder's hospitalisation costs, regardless of the disease for which they have been diagnosed. Almost all health care policies cover hospitalisation costs incurred for viral infection treatment. Since coronavirus is a viral infection, pre-and post-hospitalisation costs, along with both in-patient and out-patient expenses, are covered by a comprehensive health insurance policy.

If you're looking for a specific health insurance policy for COVID-19, standard health insurance policies will cover all medical costs incurred during COVID-19 medical treatment. In addition, all health and general insurance providers in India have the same policy terms. You must buy a health insurance plan during COVID-19, if you do not have a health plan yet. Being on the safer side is always wise and can prove to be beneficial for you when the right time comes. Ensure that you and your loved ones are protected with a health insurance plan.

Protect Your Family’s Health and Financial Future

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